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https://www.readbyqxmd.com/read/28426186/issue-at-the-heart-of-advancing-the-de-adoption-of-low-value-care-proceedings-from-an-expert-roundtable
#1
Janet Weiner, Rebecka Rosenquist
Identifying and paying for value has become a recurrent theme of health care reforms. Its corollary, reducing the prevalence of, and resources directed to, ineffective or marginally effective care, has received far less attention. In July 2016, the University of Pennsylvania’s Leonard Davis Institute of Health Economics (LDI) convened a diverse set of national leaders and stakeholders representing industry, think-tanks, provider and patient groups, and academic experts to tackle how health systems, payers, and providers can spur the ‘de-adoption’ of medical practices and technologies no longer considered valuable...
April 2017: LDI Issue Brief
https://www.readbyqxmd.com/read/28424653/disentangling-stigma-from-functional-neurological-disorders-conference-report-and-roadmap-for-the-future
#2
Karen S Rommelfanger, Stewart A Factor, Suzette LaRoche, Phyllis Rosen, Raymond Young, Mark H Rapaport
A multidisciplinary expert review of key issues and future directions from the conference "Controversial labels and clinical uncertainties: psychogenic disorders, conversion disorder, and functional symptoms." On October 9 and 10, 2015, a conference entitled "Controversial labels and clinical uncertainties: psychogenic disorders, conversion disorder, and functional symptoms" was held at the Center for Ethics, Emory University, Atlanta, GA, USA. This conference brought together a select group of 30 distinguished thought leaders and practitioners, including ethicists, researchers, clinicians, humanities scholars, and advocates to discuss the unique challenges and controversies related to the diagnosis, treatment, and stigma for patients with what is currently recognized as functional ("psychogenic") neurological disorders...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28421698/historical-harvests-reduce-neighboring-old-growth-basal-area-across-a-forest-landscape
#3
David M Bell, Thomas A Spies, Robert Pabst
While advances in remote sensing have made stand, landscape, and regional assessments of the direct impacts of disturbance on forests quite common, the edge influence of timber harvesting on the structure of neighboring unharvested forests has not been examined extensively. In this study, we examine the impact of historical timber harvests on basal area patterns of neighboring old-growth forests to assess the magnitude and scale of harvest edge influence in a forest landscape of western Oregon, USA. We used lidar data and forest plot measurements to construct 30-m resolution live tree basal area maps in lower and middle elevation mature and old-growth forests...
April 19, 2017: Ecological Applications: a Publication of the Ecological Society of America
https://www.readbyqxmd.com/read/28413148/incorporating-site-less-clinical-trials-into-drug-development-a-framework-for-action
#4
Irl B Hirsch, Joe Martinez, E Ray Dorsey, Gerald Finken, Alexander Fleming, Chris Gropp, Philip Home, Daniel I Kaufer, Spyros Papapetropoulos
PURPOSE: Options for leveraging available telemedicine technologies, ranging from simple webcams and telephones to smartphone apps and medical-grade wearable sensors, are evolving faster than the culture of clinical research. Until recently, most clinical trials relied on paper-based processes and technology. This cost- and labor-intensive system, while slowly changing, remains an obstacle to new drug development. Alternatives that use existing tools and processes for collecting real-world data in home settings warrant closer examination...
April 13, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28407424/biofilms-in-orthopedic-infections-a-review-of-laboratory-methods
#5
REVIEW
Alex C Dibartola, Matthew C Swearingen, Jeffrey F Granger, Paul Stoodley, Devendra H Dusane
Bacterial infection after hardware implantation in orthopedic surgery is a devastating issue as it often necessitates increased hospital costs and stays, multiple revision surgeries, and prolonged use of antibiotics. Because of the nature of hardware implantation into the body, these infections are commonly in the form of attached biofilms. The current literature on a range of methodologies to study clinically explanted infected orthopedic hardware, with potential biofilm, in the laboratory setting is limited...
April 2017: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
https://www.readbyqxmd.com/read/28404488/understanding-differences-between-caregivers-and-non-caregivers-in-completer-rates-of-chronic-disease-self-management-program
#6
J Shi, P McCallion, L A Ferretti
OBJECTIVES: The Chronic Disease Self-Management Program (CDSMP) was developed to advance participants' self-care of chronic illness and may be offered to both individuals with chronic conditions and their caregivers. Previous studies of CDSMP have identified multiple resulting health benefits for participants as well as factors associated with participants' completion rates. This study investigated differences on these issues between caregiving and non-caregiving participants. STUDY DESIGN: Secondary analysis using regression analysis to predict the outcome...
March 29, 2017: Public Health
https://www.readbyqxmd.com/read/28399031/the-advance-care-planning-readiness-scale-development-and-validation-of-a-measure-of-willingness-to-discuss-and-acceptance-of-end-of-life-care-in-gynecologic-cancer-patients
#7
Alaina J Brown, Megan Johnson Shen, Diana Urbauer, Jolyn Taylor, Patricia A Parker, Cindy Carmack, Lauren Prescott, Carly Rosemore, Elizabeth Kolawole, Charlotte Sun, Lois Ramondetta, Diane C Bodurka
OBJECTIVE: The objective of this article was to develop and validate a scale that assesses the readiness of gynecologic oncology patients to engage in advance care planning. METHODS: The Advance Care Planning Readiness Scale (ACPRS) was validated across 3 independent samples of gynecologic oncology patients. In step I, patients underwent cognitive interviewing to determine if the scale items were comprehensible and applicable to patients. Based on this, modifications to the scale (addition, removal, and merger of items) were completed...
April 8, 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28398367/-implantable-cardioverter-defibrillator-deactivation-at-the-end-of-life-ethical-clinical-and-communication-issues
#8
Massimo Romanò, Maria Antonella Piga, Roberta Bertona, Roberto Negro, Chiara Ruggeri, Federica Zorzoli, Rosvaldo Villani
The number of cardioverter-defibrillator implants is increasing worldwide, with the main indication being primary prevention of sudden cardiac death. During the follow-up, patients may die from progression of their underlying heart disease or from nonarrhythmic causes, such as malignancies, dementia and lung disease, without receiving appropriate shocks until the last few days or weeks of their life. These events occur roughly in 30% of patients, mainly in the last 24 hours before death. In this case, inappropriate and even appropriate shock deliveries can no longer prolong life and may simply lead to pain and reduced quality of life...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28398118/the-role-of-the-hydrogen-sulfide-pathway-in-male-and-female-urogenital-system-in-health-and-disease
#9
Roberta d'Emmanuele di Villa Bianca, Ferdinando Fusco, Vincenzo Mirone, Giuseppe Cirino, Raffaella Sorrentino
Significance The endogenous hydrogen sulfide (H<sub></sub>2<sub></sub>S) pathway produces an array of biological effects that vary depending upon the bodily region. In addition, the H<sub></sub>2<sub></sub>S pathway's relevance often changes depending upon a healthy or disease state. There is abundant evidence pointing to a key role for this pathway in male and female genito-urinary diseases suggesting it as a possible target for new therapeutic approaches. Recent Advances The tissue-specific localization of the H2S enzymes in the genito-urinary tract has allowed for a better understanding of its role in the body's pathophysiology...
April 11, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28396217/mathematical-models-of-cell-phenotype-regulation-and-reprogramming-make-cancer-cells-sensitive-again
#10
David J Wooten, Vito Quaranta
A cell's phenotype is the observable actualization of complex interactions between its genome, epigenome, and local environment. While traditional views in cancer have held that cellular and tumor phenotypes are largely functions of genomic instability, increasing attention has recently been given to epigenetic and microenvironmental influences. Such non-genetic factors allow cancer cells to experience intrinsic diversity and plasticity, and at the tumor level can result in phenotypic heterogeneity and treatment evasion...
April 7, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28393347/-an-experience-of-providing-palliative-care-in-a-long-term-care-facility-let-good-death-in-place-become-a-feasible-reality
#11
Ming-Mei Chen, Chun-Chen Chou, Kuei-Ying Hsu, Yung-Feng Yen, Ya-Ting Yang, Hsiu-Li Huang
As the number of elderly in long-term care facilities (LTCFs) continues to increase, the number of resident deaths in these facilities is expected to increase. Thus, LTCFs may become a main focus for end-of-life (EoL) care in the future. Therefore, promoting quality EoL care in LTCFs should be a priority issue. Currently, the four types of hospice services include hospice wards and hospice-share-services in hospitals and home hospice care and community hospice care in patient homes. However, to date, there has been limited discussion regarding promoting palliative care in LTCFs...
April 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28391279/perceived-control-and-aging-a-mini-review-and-directions-for-future-research
#12
Stephanie A Robinson, Margie E Lachman
This brief review on perceived control and aging is organized according to 3 perspectives of research involving description, explanation, and modification. An extensive body of literature has utilized cross-sectional and correlational methods to describe the sociodemographic variations and outcomes associated with perceived control. This work has focused on differences in perceived control as a function of age, sex, education, socioeconomic status, and culture and has identified positive associations with many aging-related outcomes involving health and well-being...
April 8, 2017: Gerontology
https://www.readbyqxmd.com/read/28379589/toxicity-and-risks-from-drug-to-drug-interactions-of-new-antivirals-for-chronic-hepatitis-c
#13
C Binda, A Tortora, M Garcovich, B E Annicchiarico, M Siciliano
The new direct acting antivirals (DAAs), defined as those drugs that are effective in combinations without interferon, have totally changed HCV treatment and probably in few years will also totally change global landscape of advanced liver diseases. The advantage of DAAs is a low-risk/high-benefit ratio. Although overall adverse events during DAAs treatment are limited in frequency and severity, some toxicity issues emerged during the first years of real-life experience with these drugs. Another peculiar characteristic of present DAAs is a high probability of interaction with other "common-use" drugs, such as anti-hypertensive, anti-platelet, antiarrhythmic and cholesterol lowering agents...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28374641/why-highly-effective-drugs-are-not-enough-the-need-for-an-affordable-solution-to-eliminating-hcv
#14
C Nelson Hayes, Kazuaki Chayama
Because of the rapid pace of development of new direct-acting antiviral (DAA) drugs, chronic hepatitis C virus (HCV) infection is now increasingly considered curable. However, the emphasis on DAA therapies disregards key issues related to cost, availability, and antiviral resistance. Areas covered: This perspective provides an overview of current HCV therapies and the development of DAAs, followed by a discussion of the limitations of DAA therapy. A literature search was used to select relevant studies, and a web search for relevant news articles and press releases was conducted...
April 4, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28372988/topodynamics-of-metastable-brains
#15
REVIEW
Arturo Tozzi, James F Peters, Andrew A Fingelkurts, Alexander A Fingelkurts, Pedro C Marijuán
The brain displays both the anatomical features of a vast amount of interconnected topological mappings as well as the functional features of a nonlinear, metastable system at the edge of chaos, equipped with a phase space where mental random walks tend towards lower energetic basins. Nevertheless, with the exception of some advanced neuro-anatomic descriptions and present-day connectomic research, very few studies have been addressing the topological path of a brain embedded or embodied in its external and internal environment...
March 23, 2017: Physics of Life Reviews
https://www.readbyqxmd.com/read/28371494/quality-by-control-towards-model-predictive-control-of-mammalian-cell-culture-bioprocesses
#16
REVIEW
Wolfgang Sommeregger, Bernhard Sissolak, Kulwant Kandra, Moritz von Stosch, Martin Mayer, Gerald Striedner
The industrial production of complex biopharmaceuticals using recombinant mammalian cell lines is still mainly built on a quality by testing approach, which is represented by fixed process conditions and extensive testing of the end-product. In 2004 the FDA launched the process analytical technology initiative, aiming to guide the industry towards advanced process monitoring and better understanding of how critical process parameters affect the critical quality attributes. Implementation of process analytical technology into the bio-production process enables moving from the quality by testing to a more flexible quality by design approach...
March 31, 2017: Biotechnology Journal
https://www.readbyqxmd.com/read/28370939/stent-mediated-gene-and-drug-delivery-for-cardiovascular-disease-and-cancer-a-brief-insight
#17
REVIEW
Akshaya Krishnagopal, Aakash Reddy, Dwaipayan Sen
AIM: This article concisely recapitulates the different existing modes of stent mediated gene/drug delivery, their considerable advancements in clinical trials and a rationale of other merging new technologies such as nanotechnology and microRNA based therapeutics, furthermore addressing the breach in each of these perpetual stent platforms. DISCUSSION: Over the past decade stent mediated gene/drug delivery have materialized as a hopeful alternative for cardiovascular disease and cancer in contrast to the routine conventional treatment modalities...
March 31, 2017: Journal of Gene Medicine
https://www.readbyqxmd.com/read/28370025/ancient-plant-dna-in-lake-sediments
#18
REVIEW
Laura Parducci, Keith D Bennett, Gentile Francesco Ficetola, Inger Greve Alsos, Yoshihisa Suyama, Jamie R Wood, Mikkel Winther Pedersen
Contents I. II. III. IV. V. VI. VII. VIII. IX. X. XI. References SUMMARY: Recent advances in sequencing technologies now permit the analyses of plant DNA from fossil samples (ancient plant DNA, plant aDNA), and thus enable the molecular reconstruction of palaeofloras. Hitherto, ancient frozen soils have proved excellent in preserving DNA molecules, and have thus been the most commonly used source of plant aDNA. However, DNA from soil mainly represents taxa growing a few metres from the sampling point. Lakes have larger catchment areas and recent studies have suggested that plant aDNA from lake sediments is a more powerful tool for palaeofloristic reconstruction...
April 3, 2017: New Phytologist
https://www.readbyqxmd.com/read/28364247/intracerebroventricular-delivery-in-mice-for-motor-neuron-diseases
#19
M Nizzardo, M Rizzuti
The use of antisense oligonucleotides to target specific mRNA sequences represents a promising therapeutic strategy for neurological disorders. Recent advances in antisense technology enclose the development of phosphorodiamidate morpholino oligomers (MO), which is one of the best candidates for molecular therapies due to MO's excellent pharmacological profile.Nevertheless, the route of administration of antisense compounds represents a critical issue in the neurological field. Particularly, as regards motor neuron diseases, intracerebroventricular (ICV) injection is undoubtedly the most efficient procedure to directly deliver therapeutic molecules in the central nervous system (CNS)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28356008/the-evolutionary-tale-and-future-directions-of-aromatase-inhibitors-in-breast-carcinoma
#20
Dipanjan Bhattacharjee, Meena K Kumari, S Avin, Mohan V Babu Amberkar
Aromatase inhibitors have often been likened to that of 'medical scalpels' for the treatment of breast carcinoma. By inhibiting the singular step of aromatisation, they have proven to be extremely effective allies in the treatment of breast cancer among postmenopausal women. However, their relevance soon may not be limited to the post-menopausal age group alone. Recent studies have hinted at their utility amongst the pre-menopausal women; combined with ovarian ablation techniques, aromatase inhibitors may prove to be equally effective and more, as compared to tamoxifen in this age-group...
March 27, 2017: Anti-cancer Agents in Medicinal Chemistry
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